Every client is unique, so there is no one-size-fits-all solution to resistance — but these strategies may help push past hostility and start building a strong therapeutic relationship.
1. Build rapport.
The therapeutic alliance — that is, the relationship between client and clinician — is among the best predictors of success in therapy, so strengthening the rapport with a resistant patient is crucial. Using humor and looking for shared interests can help with that, Jodoin says, as can practicing a little patience. “I try not to push them to disclose things to me before they’re ready,” she says, as doing so can fracture trust and make the relationship even more contentious.
2. Try self-disclosure.
Therapists are often hesitant to talk about themselves, but tactful self-disclosure can go a long way toward building an open, trusting relationship with a difficult client. Jodoin, who practices cognitive behavioral therapy, says she often tells her clients that she experiences the same sorts of negative thought patterns that she’s trying to help them change. “I show them I’m a human in the room with them and show them it’s a collaborative relationship,” she says.
3. Offer validation.
When a resistant client does open up, even a little bit, it’s important to validate their feelings and experiences so that they feel comfortable in therapy and are encouraged to explore further, Jodoin says.
4. Establish goals.
Asking a client what they want to get out of therapy is always a good idea, but particularly so when resistance is an issue. Jodoin frequently sees young clients who are in therapy because their parents want them to work on something. Instead of focusing on what their parents want, she says, it’s helpful to ask the client what they want to talk about or achieve.
5. Play a game.
“One of the best strategies I implement when working with a teen who is resistant is to play a game,” explains Michael Heckendorn, Headway’s Manager of Clinical Education. “Let the game be the driver of therapeutic conversations or simply let it be a tool to build rapport.”
Some examples? UNO, Go Fish, Connect 4, or simply throwing an emotions Thumball.
6. Note their resistance.
Sometimes, it’s helpful to address the elephant in the room head-on. With a young client, “I’d say something like, ‘Look, I get it. Your parents want you to be here. It makes sense that you’re feeling annoyed that they’re pressing you to be here,’” Jodoin says. Doing so gives the client a chance to express their feelings about the situation.
7. Assess the fit.
Sometimes, a client-therapist match just isn’t right. If client resistance does not improve at all over time, that may be a sign that they’d be better served by a different clinician or style of therapy. If that seems to be the case, you can discuss the situation with your client and provide referrals to other providers if appropriate.
